Guillain-Barre Syndrome Flashcards
Define Guillain-Barre Syndrome?
Acute inflammatory demyelinating polyneuropathy
What is the aetiology of Guillain-Barre Syndrome?
An inflammatory process where antibodies after a recent infection react with self-antigen on myelin or neurons
There is often no aetiological trigger identified (40% of cases are idiopathic)
What are the other causes of Guillain-Barre Syndrome?
Post-infection (1-3 weeks) - bacterial, HIV, herpes viruses
Malignancy - e.g. lymphoma
Post-vaccination
What is the epidemiology of Guillain-Barre Syndrome?
UK incidence: 1-2/100,000
Affects all age groups
What are the presenting symptoms of Guillain-Barre Syndrome?
PROGRESSIVE SYMPTOMS
<1 month duration:
- Ascending symmetrical limb weakness (lower > upper)
- Ascending paraesthesia
Cranial nerve involvement
Respiratory muscles may be affected in SEVERE cases
Miller-Fisher Variant (RARE)
What can Cranial Nerve Involvement lead to in Guillain-Barre Syndrome?
Dysphagia
Dysarthria
Facial weakness
What are the presenting symptoms of the Miller-Fisher Variant in Guillain-Barre Syndrome?
Ophthalmoplegia
Ataxia
Arreflexia
What are the signs of Guillain-Barre Syndrome on General MOTOR examination?
Hypotonia
Flaccid paralysis
Arreflexia (ascending upwards from feet to head)
What are the signs of Guillain-Barre Syndrome on the general sensory examination?
Impairment of sensation in multiple modalities (ascending from feet to head)
What cranial nerve palsies do you see for Guillain-Barre Syndrome?
Facial nerve weakness
Abnormality of external ocular movements
If pupil constriction is affected, consider botulism
Why is there Type II Respiratory Failure for Guillain-Barre Syndrome?
Due to paralysis of respiratory muscles
How do we check the Autonomic function of Guillain-Barre Syndrome?
Assess postural BP change and arrhythmias
What investigations do you do for Guillain-Barre Syndrome?
Lumbar Puncture Nerve Conduction Study Bloods Spirometry ECG
What do we see on a Lumbar Puncture for Guillain-Barre Syndrome?
HIGH protein
NORMAL cell count and glucose
What do we see on a Nerve Conduction Study for Guillain-Barre Syndrome?
Reduced conduction velocity
It may be normal in the early stages of the disease
